A&E departments could collapse in SIX months, warns top health chief

EMERGENCY health care could collapse in six months after a dramatic increase in the number of patients attending hospital.

Accident and emergency wards have seen a rise of more than a million patients

More than 18.3million people visited accident and emergency (A&E) wards in England last year - a rise of a million from the year before.

A top health official has called on Health Secretary Jeremy Hunt to push through controversial NHS changes as soon as possible.

Chris Hopson, chief executive of the Foundation Trust Network which represents more than 200 health trusts in England, said: "A&E services have been under huge pressure andalthough performance is now stabilising, there is a danger the system will fall over in six months time unless we plan effectively for next winter."

He added that the current model of emergency care was unsustainable.

"NHS England has already done good work on developing a new model," he said.

"We need Jeremy Hunt to commit to completing and then implementing the results of that work as quickly as possible, even though it's likely to involve difficult decisions in the run-up to the General Election.

"These include relooking at the GP contract, reconfiguring some hospital A&E departments and investing more in community facilities."

I think one of the problems we have at the moment is that it is too difficult to access out-of-hours care.

Health Secretary Jeremy Hunt

Health Secretary Jeremy Hunt blamed the previous Labour government for some of the problems, and said changes to the way out-of-hours care is provided had a "huge impact" on the services.

Mr Hunt said there was a "dramatic fall in confidence" in evening and weekend non-urgent cover since the last government changed the GP contract in 2004 to remove responsibility for out-of-hours care from family doctors.

"What we need to do is to have a very fundamental look at the way A&E departments work and in particular look at the alternatives to A&E because the Government changed the GP contract in 2004 and they removed responsibility for out-of-hours care from GPs," he told ITV Daybreak.

"That has caused a dramatic fall in confidence in the public in what their alternatives to A&E are - that is what we have to sort out."

In an interview with BBC Breakfast, Mr Hunt said since the contract was changed there were now four million more people visiting A&E departments every year.

"I think one of the problems we have at the moment is that it is too difficult to access out-of-hours care," he said.

A spokesman for Labour's shadow Health Secretary Andy Burnham said it is surprising the government is blaming the patient increase on contracts which were signed nearly ten years ago.

He said: "The contracts had already been in place for five years by the time we left office in 2010.

"We saw 98 per cent of people being treated in less than four hours at A&E, but now one in three people are waiting for more than four hours."

The spokesman said GPs are closing their surgery doors earlier as their is no incentive to keep them open, and the government's new non-emergency 111 service which replaced NHS Direct is not fit for purpose.

Health Secretary Jeremy Hunt has blamed the previous government for the pressure on A&E departments

Earlier today, the College of Emergency Medicine (CEM) called for "fundamental change" in the way emergency care is run, warning that A&E units are facing their biggest challenge in more than a decade as departments grapple with "unsustainable workloads" and lack of staff.

The College also said that there should be a GP service within hospitals which could cater for as much as 30% of the current traffic which is presently seen in emergency departments.

Dr Taj Hassan, vice president of the college, said: "It is clear that working environments for them (consultants and middle grade doctors) at times are intolerable, associated with risk for them and their patients, and that action is required to stabilise our systems.

"The report has come at a timely juncture where our regulatory bodies and policy makers have also recognised this to be a crisis and suggested urgent action is merited.

"Our recommendations are based upon the need for close collaboration, system redesign, appropriate funding and sustainable working practices for care delivery and training."

The latest data from the Health and Social Care Information Centre show almost two-fifths (39 per cent) of those who were seen by A&E doctors between February 2012 and January 2013 were discharged with no follow up - meaning the patient did not require any further treatment or advice about their condition.

The number of patients who were admitted or referred on remained broadly similar, the provisional statistics suggest.